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Defining the role of CD2 in disease progression and overall survival among patients with completely resected stage-II to -III cutaneous melanoma

Sara Harcharik, Sebastian Bernardo, Marina Moskalenko, Michael Pan, Meera Sivendran, Heather Bell, Lawrence D. Hall, Mireia Castillo-Martín, Kelly Fox, Carlos Cordon-Cardo, Rui Chang, Shanthi Sivendran, Robert G. Phelps, Yvonne Saenger

Journal of the American Academy of Dermatology, In Press, March 2014

Editors' comments: Dr. James Larkin
Harcharik and colleagues report an association of CD2 positivity and risk of relapse in a retrospective cohort of 90 stage 2 and 3 melanoma patients over almost 10 years. This association does not define the role of CD2 in disease progression but is of interest and requires investigation in independent datasets.

Background

Accurate assessment of prognosis remains clinically challenging in stage II to III cutaneous melanoma. Studies have implicated CD2 in immune surveillance, T-cell activation, and antitumor immunity, but its role in melanoma progression warrants further investigation.

Objective

We sought to investigate the prognostic role of CD2 in primary cutaneous melanoma.

Methods

Patients with American Joint Committee on Cancer stage II and III cutaneous melanoma were identified by retrospective review of dermatopathology databases from 2001 to 2010 at Mount Sinai Medical Center and Geisinger Medical Center. Additional patients were provided by New York University Medical Center based on retrospective review and tissue availability. Immunohistochemistry was performed on tumors from 90 patients with known recurrence status and documented follow-up.

Results

Primary tumors from patients who developed recurrent disease had fewer CD2+ cells (P = .0003). In multivariable analyses including standard clinicopathologic predictors, CD2 was an independent predictor of disease recurrence (P = .008) and overall survival (P = .007). CD2 count correlated with characterization of tumor-infiltrating lymphocytes (P = .0004). Among the intermediate prognosis group of patients with nonbrisk tumor-infiltrating lymphocytes, CD2 count was predictive of disease recurrence (P = .0006) and overall survival (P = .0318).

Limitations

Our retrospective design may have resulted in incomplete representation of patients lacking documented follow-up.

Conclusions

CD2 may be an independent predictor of disease recurrence and overall survival among patients with primary cutaneous melanoma.